The Walking Wounded Among Us. Why You Should Take Sepsis More Seriously.
Hey there Summit County and all you wonderful mountain lovers. This blog post is for you. Well, technically they are all for you, but this one especially. Since I am your resident Derm-Nerd, I wanted to talk to you about a very real problem here in Colorado (and world-wide) with a very sneaky killer called Sepsis.
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I wanted to take this time together to raise some, I believe, much needed awareness for the rising problem of Sepsis (especially in Colorado) and how it can develop from your skin (whether it occurs from a simple scrape, cut, puncture wound, surgical wound, tattoo, etc) or develops from basically any other type of infection throughout your body that isn't treated appropriately.
If you have never heard of Sepsis, or it doesn't really ring any bells in your immediate recall, no worries...Just stay with me, keep on reading, and in about 10 minutes or less, you will definitely be "in the know." :)
WHAT IS SEPSIS?
The definition of sepsis, according to the Sepsis.org website, is; "the body’s overwhelming and potentially life-threatening response to infection that can lead to tissue damage, organ failure, and death. In other words, it’s your body’s over active and toxic response to an infection."
Frankly, the reason you could get signs and symptoms related to sepsis is that your immune system stops fighting the infection that gets into your body, the infection spreads into your bloodstream, and your immune system starts malfunctioning by fighting against itself/your own tissues/organs/etc.
The immune system is your bodies natural defense against the invaders, whether the culprit is bacteria, viruses, fungus, or parasites such as worms. (EEEWWWW...said EVERYONE reading this, right?) We all get some type of infection from time to time. Whether it be a common cold or flu virus, a cut or scrape from an amazing outdoor adventure (like any number of choices here in Summit County), or may be from something we ate....and all of a sudden, we feel sick.
Now sometimes, you may not even realize you have an infection that needs to be treated or know if your immune system starts responding abnormally (which is usually difficult to detect until you are either feeling really sick or getting lab tests done along with a thorough evaluation in a medical setting).
The infection can be spreading in your bloodstream and shutting down your organs before you even realize you are in trouble. Pretty scary, right?
That is why so many organizations and medical providers are determined to get the word out to the general public so people have a better chance at complete recovery, without complications such as limb amputations, mental or physical deficits, and/or permanent organ damage.
It is important to remember that even healthy people can develop sepsis. And, the challenge is that some people are more at risk than others. Here are the folks who need to be on heightened alert:
* People whose immune systems are not functioning well because of an illness (such as diabetes or AIDS)
* Individuals on medical treatments that weaken the immune system (such as biologic medications for psoriasis, chemotherapy for cancer, or steroids for a number of medical conditions)
* Newborn and premature babies are especially at risk because their immune systems are not completely developed, but children less than 1 year old are also at higher risk.
* The elderly population, especially those with multiple medical illnesses on multiple medications, may be at increased risk as well.
* Hospitalized patients are at risk to develop sepsis from infections due to intravenous lines, catheters, surgical wounds, and/or bedsores.
SEPSIS. THE STEALTH KILLER.
As your resident Colorado Derm-Nerd, you know that I can get a little hyper about the numbers. You could call me a "statistic junkie." So, let's put some numbers in your mind that show how dangerous sepsis really is.
Now in addition to the numbers above for Colorado and the US, recent statistics in 2015 have shown that approximately 30 MILLION people world-wide are affected by sepsis each year! As you can see from this information, this is a REAL problem that can happen to any one of us, yet few outside the medical field really know about it. And like many other conditions I have already blogged about, sepsis does not discriminate and can attack any age, race, sex, or socioeconomic status.
To give you a little perspective, sepsis will kill more people than car accidents, breast cancer, HIV and strokes COMBINED. WOW.... read that statistic again slowly to let it fully sink in.
In addition, the cost of dealing with sepsis and sepsis-related illnesses is staggering. According to Jim O’Brien, Vice President of Quality and Patient Safety at Ohio Health Riverside Methodist Hospital, in a 2015 CDC Safe Healthcare blog (see link below), sepsis is the most expensive reason for hospitalization. Over half a BILLION dollars in Colorado alone is spent annually on fighting and treating this condition. And nationwide it is estimated that approximately $55,616,438 is spent on sepsis care in US hospitals EVERY DAY!
HOW DOES A PERSON GET SEPSIS?
Here's where this gets really crazy. About 20 years ago, when I first started my career in medicine as an Emergency Room technician, a wise old ER doc likened sepsis to a "cunning, stealthy ninja that can sneak up on you like a seasoned and well-trained assassin." And, as an Emergency Room Physician Assistant for 7.5 years, I was able to personally catch and disarm this ninja more times than I can count. Now, as a Dermatology Physician Assistant since 2010, I make it my mission to catch skin infections before they can turn into sepsis. But you have to know what you are looking for to know when to get some help! That's why I do my best to fit patients (new and established) into my schedule within 24-48 hours and always recheck my surgical patients as many times as needed after a procedure for optimal results including, but not limited to, immediate treatment when any indications to suggest infection are present.
As we talked about in the opening paragraph of this blog, sepsis is a direct result of infection invading the body and then the bloodstream, and can be coupled with a weakened or malfunctioning immune system.
And remember, that infection can be triggered by multiple different sources including bacteria, viruses, fungus, or parasites. Here are some examples of originating sites of infection that could lead to sepsis:
- Lung infection
- Skin infection or "cellulitis" (see more below)
- A simple scratch or cut
- A biopsy or excision site
- Getting a tattoo
- An infected cyst
- A urinary tract infection
- A gastrointestinal infection
PAY ATTENTION TO THE SYMPTOMS OF CELLULITIS
This problem is personal to me since it is a bacterial infection that affects your skin and the tissues under your skin.
What looks like a simple pimple, red bump or bug bite, is a potential gateway to sepsis and should be evaluated by a medical provider immediately with any concerns (such as rapidly growing in size, getting warm, increasing pain, red streaking away from original site, draining pus, fever, etc). This isn't meant to cause you unnecessary stress, worry or fear, but I need to remind you that sepsis is not only preventable, but more importantly, can be curable without complications if caught early enough.
Again, to recap.....Cellulitis can happen anywhere on the body and may include the following: redness, pain, drainage, fever, swelling, tenderness and warm to the touch skin.
SYMPTOMS OF SEPSIS - NO PAY ATTENTION FOLKS
The symptoms are many and can be simple as well as complex. Unfortunately for medical providers, not all patients who present with sepsis "read the textbook" on how it is SUPPOSED to look and every individual's body can handle the infection differently.
That is why the CDC and world-wide Sepsis campaigns encourage individuals to ask their medical providers "Could this infection be leading to sepsis?" By asking this simple question, sepsis is always in the differential diagnosis and not overlooked since the consequences of missing this condition can be so profound.
As previously mentioned, a journey to sepsis can start with something as mundane as an everyday scrape or cut while hiking in the mountains. But this simple injury can spiral into the worst nightmare imaginable, and for some it only takes a few days to take their lives.
Please take 1 minute to watch the video below about common folks, like you or I, with loved ones who have had first-hand experience of this nightmare....
Did you catch all the signs in the video? And what's more, did you catch where each family member said that their medical providers DIDN'T suspect sepsis in their diagnosis? The well-trained stealthy assassin strikes again....
Those affected by sepsis can feel any of the following symptoms below. But, here is the catch: sometimes, you may not experience any unusual symptoms until you are already in trouble. So you must ACT FAST!
PAY ATTENTION. These symptoms could develop in your life or in the life of someone close to you. And multiple studies show that getting thorough, comprehensive and aggressive treatment within 6 hours of a sepsis diagnosis or suspected sepsis is critical for best outcomes.
Feeling cold, shivering, or having a fever with or without flu-like symptoms? SEEK MEDICAL HELP IMMEDIATELY!
Feel like you are "going to die" or are in the "worst pain of my life?" SEEK MEDICAL HELP IMMEDIATELY!
"Not looking so good", with pale or discolored skin? SEEK MEDICAL HELP IMMEDIATELY!
Feeling sleepy, confused, or lethargic? SEEK MEDICAL HELP IMMEDIATELY!
Having shortness of breath or a fast heart rate? SEEK MEDICAL HELP IMMEDIATELY!
Knowing about sepsis and telling your medical provider you may be experiencing signs or symptoms of sepsis helps set you up for a win in the "race against time".
POTENTIAL CONSEQUENCES OF SEPSIS
* Death. There is no easy way to say this and I don't want to sugar-coat the issue... the worst case scenario for sepsis is death. And as you noticed in the video, there is no set time for this to occur. Sepsis is fatal for some after just a few days and for others it may take several days to weeks.
* Organ failure. When your body gets infected, your immune system can malfunction and is unable to fight whatever is causing the infection, so your organs can start to shut down. This process can develop and progress rapidly, affecting any organ in the body.
* Decreased cognitive or physical function. According to the "Life After Sepsis" page on Sepsis.org, "almost 60% of sepsis survivors experience worsened cognitive (mental) and/or physical function. This can include memory loss, chronic pain, and chronic fatigue and should be managed by specialists who have experience with patients who have won the battle with sepsis.
* PTSD (Post-Traumatic Stress Disorder). In addition to PTSD, many sepsis survivors also suffer with chronic nightmares, anxiety and depression. Getting help with trained counselors and support groups is key in dealing with these after-effects of sepsis.
* Amputation. Learn about Christine Lentz's story. Watch the video below.
WHY IS THIS SUBJECT IMPORTANT?
We are Coloradans. We are a very active bunch. We inspire others to be more active. Just look at the millions that visit my neck of the woods every year.
MENTAL NOTE: When you are active, you are more prone to have scrapes, cuts, lacerations, and puncture wounds. Also, when you socialize with others frequently or work in close quarters, colds and other viruses are spread more rapidly. Practicing good hygiene, such as hand-washing often, and keeping cuts clean until healed may save your life. Get medical care IMMEDIATELY when an infection is not getting better or if it seems to be getting worse.
Plus, even though there is a growing sense of awareness about sepsis, the numbers of people getting sepsis are actually on the rise. So what does this information mean? The answer is simple: The problem is not being recognized or managed appropriately...YET. But I am confident with social media and our network of people who like to help others, we CAN do better. Share this blog so friends, family members, or someone you have never met has a chance against this aggressive and potentially fatal condition.
How else can you help? Spread the word that Sepsis is a KILLER. Learn and teach others how to recognize the symptoms that in many cases can mimic other diagnoses.
Sepsis is preventable. Stand tall and feel empowered knowing that you can save a life by having a little bit more knowledge.
Hopefully, you have found this blog useful. But you know what? Don't just read it and forget about it, SHARE IT!!! Keep it in your recall database. Better yet, post about a close call or a personal experience with sepsis for you or someone you know.
Stay safe out there Colorado. The snow has been coming down off and on since last night so hopefully I'll see you on the slopes soon in Summit County! ;)
Kelly Ballou, PA-C
Co-Founder Renew Dermatology Frisco, Colorado (Summit County)
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